Acupuncture versus valproic acid in the prophylaxis of migraine without aura: a prospective controlled study

Background. The pharmacologic treatment of migraine still remains below the expectations. The aim of this study is to compare the effectiveness of traditional acupuncture and valproic acid in migraine prophylaxis. Methods. A prospective, controlled study was performed in 100 patients affected by migraine without aura lasting for over one year. The patients were stratified for sex and randomly divided into two groups of 50 patients each. Patients belonging to Group A (acupuncture) were submitted to 20 sessions of acupuncture, while patients belonging to Group V valproate) were administered Valproic acid (Depakin Chrono (R)) at a dose of 600 mg/day; 10 mg Rizatriptan wafers were allowed as needed to treat the attacks. The Midas Index (MI) and pain intensity (PI, by VAS) were recorded before treatment (T-0), at three (T-1) and six (T-2) months; a six-point scale Pain Relief score (PRS), the Rizatriptan intake and adverse events were recorded at T-1 and T-2. Results. Eighty-two out of 100 patients completed the study (9 dropouts in each group). In both groups the MI improved at T-1 and T-2 (P<0.0001). Pain intensity was better at T-1 in group V (P<0.0001), but PI and PRS (P=0.02) as well as rizatriptan intake (P=0.001) were better in group A at T-2. The rate of adverse events was 47.8% in group V and 0% in group A. Conclusion. Our data show a lower pain intensity and lower Rizatriptan intake at six-months follow-up with no adverse events in acupuncture patients compared to those treated with valproic acid.